Investigating the Relationship Between Health Literacy and Anxiety Related to COVID-19 Among Students of the Faculty of Health, Semnan University of Medical Sciences

Pejman Sheikhha; Shayan Ahmadnezhad; Mohammad Ezati Asar; Elahe Saleh

doi:10.5812/koomesh-150399

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https://doi.org/10.69107/koomesh-150399

Investigating the Relationship Between Health Literacy and Anxiety Related to COVID-19 Among Students of the Faculty of Health, Semnan University of Medical Sciences

Author(s):

Pejman Sheikhha

¹,

Shayan Ahmadnezhad

¹,

Mohammad Ezati Asar

^{2, 3},

Elahe Saleh

^{2, 4,*}

1Student Research Committee, Semnan University of Medical Sciences, Semnan, Iran

2Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran

3Department of Public Health, School of Health, Semnan University of Medical Sciences, Semnan, Iran

4Department of public health, School of Health, Semnan University of Medical Sciences, Semnan, Iran

Koomesh:Vol. 27, issue 2; e150399

Published online:May 13, 2025

Article type:Research Article

How to Cite:Sheikhha P, Ahmadnezhad S, Ezati Asar M, Saleh E. Investigating the Relationship Between Health Literacy and Anxiety Related to COVID-19 Among Students of the Faculty of Health, Semnan University of Medical Sciences. koomesh. 2025;27(2):e150399. doi: https://doi.org/10.69107/koomesh-150399

Abstract

Background: Health literacy refers to individuals' ability to access, analyze, and understand basic health information and services, enabling them to make informed decisions about their health. Developing health literacy can have a significant impact on individuals' lives. By utilizing health literacy, individuals can acquire accurate information about diseases, their prevention, and available treatments, leading to improved quality of life, increased hope, and reduced rates of diseases and mortality. During the COVID-19 pandemic, individuals experienced severe anxiety.

Objectives: This research aims to investigate the impact of health literacy on COVID-19 anxiety.

Methods: This cross-sectional analytical study was conducted on 110 health major students (public, environmental, and occupational) at the Semnan University of Medical Sciences in 2022 using stratified random sampling. Data was collected through the Health Literacy Questionnaire (HELIA) and the Coronavirus Disease Anxiety Scale (CDAS Questionnaire), and multiple regression analysis was used to examine the impact of health literacy on COVID-19 anxiety.

Results: Health literacy levels were assessed as 18.2% excellent, 60% sufficient, 20.9% borderline, and 0.9% inadequate. The level of COVID-19 anxiety was evaluated as 1.89% mild, 10% moderate, and 0.9% severe. Health literacy had a significant inverse effect on COVID-19 anxiety (P = 0.018, B = -0.25).

Conclusion: Educating and promoting health literacy concepts in universities, educational environments, and interventions are very important. Utilizing the available resources to conduct educational classes and counseling sessions, and incorporating supplementary workshops on health promotion, nutrition, and other health-related topics into students' academic programs, is essential to enhance health literacy.

Keywords

References

1.
Ad Hoc Committee on Health Literacy for the Council on Scientific Affairs AMA. Health Literacy: Report of the Council on Scientific Affairs. J Am Med Assoc. 1999;281(6):552-7. https://doi.org/10.1001/jama.281.6.552.
2.
Tavousi M, Ebadi M, Azin A, Shakerinejad G, Hashemi A, Fattahi E, et al. [Definitions of health literacy: a review of the literature]. Payesh (Health Monitor) J. 2014;13(1):119-24. Persian.
3.
Berkman ND, Davis TC, McCormack L. Health literacy: what is it? J Health Commun. 2010;15 Suppl 2:9-19. [PubMed ID:20845189]. https://doi.org/10.1080/10810730.2010.499985.
4.
Kickbusch IS. Health literacy: addressing the health and education divide. Health Promot Int. 2001;16(3):289-97. [PubMed ID:11509466]. https://doi.org/10.1093/heapro/16.3.289.
5.
World Health Organization. Closing the gap in a generation: health equity through action on the social determinants of health: Commission on Social Determinants of Health final report. Geneva, Switzerland: World Health Organization; 2008 Contract No.: Document Number|.
6.
Ahmadi FZ, Mehr-Mohammadi M, Talaee E, Fardanesh H, Paknahad M, Taghizadeh S, et al. [Health Literacy among students of Farhangian University]. Payesh (Health Monitor) J. 2018;17(3):257-66. Persian.
7.
Baker DW, Wolf MS, Feinglass J, Thompson JA, Gazmararian JA, Huang J. Health literacy and mortality among elderly persons. Arch Intern Med. 2007;167(14):1503-9. [PubMed ID:17646604]. https://doi.org/10.1001/archinte.167.14.1503.
8.
Javadzade SH, Sharifirad G, Radjati F, Mostafavi F, Reisi M, Hasanzade A. Relationship between health literacy, health status, and healthy behaviors among older adults in Isfahan, Iran. J Educ Health Promot. 2012;1:31. [PubMed ID:23555134]. [PubMed Central ID:PMC3577376]. https://doi.org/10.4103/2277-9531.100160.
9.
Howard DH, Sentell T, Gazmararian JA. Impact of health literacy on socioeconomic and racial differences in health in an elderly population. J Gen Intern Med. 2006;21(8):857-61. [PubMed ID:16881947]. [PubMed Central ID:PMC1831584]. https://doi.org/10.1111/j.1525-1497.2006.00530.x.
10.
Khaleghi M, Amin Shokravi F, Peyman N. [The Relationship Between Health Literacy and Health-Related Quality of Life in Students]. Iran J Health Educ Health Prom. 2019;7(1):66-73. Persian. https://doi.org/10.30699/ijhehp.7.1.66.
11.
Vernon JA, Trujillo A, Rosenbaum SJ, DeBuono B. Low health literacy: Implications for national health policy; 2007 Contract No.: Document Number|.
12.
Stocks NP, Hill CL, Gravier S, Kickbusch L, Beilby JJ, Wilson DH, et al. Health literacy-a new concept for general practice? Australian Fam Physician. 2009;38(3):144-6.
13.
Kickbusch I, Pelikan JM, Apfel F, Tsouros AD. Health literacy: the solid facts. Copenhagen: World Health Organization. Regional Office for Europe; 2013. p. vi, 73 p.
14.
Fransen MP, Van Schaik TM, Twickler TB, Essink-Bot ML. Applicability of internationally available health literacy measures in the Netherlands. J Health Commun. 2011;16 Suppl 3:134-49. [PubMed ID:21951248]. https://doi.org/10.1080/10810730.2011.604383.
15.
Dehghankar L, Panahi R, Kekefallah L, Hosseini N, Hasannia E. The study of health literacy and its related factors among female students at high schools in Qazvin. J Health Literacy. 2019;4(2):18-26. https://doi.org/10.22038/jhl.2019.40390.1055.
16.
Sheikh Sharafi H, Seyed amini B. [Assessment of health literacy and self-care in heart failure patients]. J Health Literacy. 2017;1(4):203-19. Persian. https://doi.org/10.22038/jhl.2017.10854.
17.
Tavousi M, Haeri Mehrizi A, Rafiefar S, Solimanian A, Sarbandi F, Ardestani M, et al. [Health literacy in Iran: findings from a national study]. Payesh (Health Monitor) J. 2016;15(1):95-102. Persian.
18.
Karimi S, Keyvanara M, Hosseini M, Jafarian M, khorasani e. [Health Literacy, Health Status, Health Services Utilization and Their Relationships in Adults in Isfahan]. Health Inform Management. 2014;10(6):862-75. Persian.
19.
Skevington SM, Lotfy M, O'Connell KA, Whoqol Group. The World Health Organization's WHOQOL-BREF quality of life assessment: psychometric properties and results of the international field trial. A report from the WHOQOL group. Qual Life Res. 2004;13(2):299-310. [PubMed ID:15085902]. https://doi.org/10.1023/B:QURE.0000018486.91360.00.
20.
Zhang Q, Cui G. Investigation and analysis of Xi'an college students' health literacy. Proceedings 2011 International Conference on Human Health and Biomedical Engineering; 19-22 Aug. 2011. 2011. p. 994-7.
21.
Vozikis A, Drivas K, Milioris K. Health literacy among university students in Greece: determinants and association with self-perceived health, health behaviours and health risks. Arch Public Health. 2014;72(1):15. [PubMed ID:24987522]. [PubMed Central ID:PMC4066308]. https://doi.org/10.1186/2049-3258-72-15.
22.
Ramezankhani A, Ghafari M, Rakhshani F, Ghanbari S, Azimi S. [Comparison of health literacy between medical and non-medical students in Shahid Beheshti Universities in the academic year 92-93]. Pajoohande. 2015;20(2):78-85. Persian.
23.
Panahi R, Ramezankhani A, Tavousi M, Osmani F, Ghazanfari E, Niknami S. [Evaluation of Health Literacy and its influencing factors on dormitory students of Shahid Beheshti University of Medical Sciences in Tehran]. J Educ Commun Health. 2017;3(3):30-6. Persian. https://doi.org/10.21859/jech-03035.
24.
Sajadi FA, Sajadi HS, Panahi R. [Health Literacy of University Students and its Influential Factors: A Case Study at Isfahan University]. J Educ Commun Health. 2020;7(1):23-8. Persian. https://doi.org/10.29252/jech.7.1.23.
25.
Mohammadi Farah S, Saati Asr MH, Kavivani Manesh A, Barati M, Afshari M, Mohammadi Y. [Health Literacy Level and its Related Factors among College Students of Hamadan University of Medical Sciences, Hamadan, Iran]. J Educ Commun Health. 2017;4(2):11-7. Persian. https://doi.org/10.21859/jech.4.2.11.
26.
Leung AYM, Parial LL, Tolabing MC, Sim T, Mo P, Okan O, et al. Sense of coherence mediates the relationship between digital health literacy and anxiety about the future in aging population during the COVID-19 pandemic: a path analysis. Aging Ment Health. 2022;26(3):544-53. [PubMed ID:33438448]. https://doi.org/10.1080/13607863.2020.1870206.
27.
Wang C, Pan R, Wan X, Tan Y, Xu L, Ho CS, et al. Immediate Psychological Responses and Associated Factors during the Initial Stage of the 2019 Coronavirus Disease (COVID-19) Epidemic among the General Population in China. Int J Environ Res Public Health. 2020;17(5). [PubMed ID:32155789]. [PubMed Central ID:PMC7084952]. https://doi.org/10.3390/ijerph17051729.
28.
Choi J. Taylor, S. (2019). The psychology of pandemics: Preparing for the next global outbreak of infectious disease. Newcastle upon Tyne, UK: Cambridge Scholars Publishing. Asian Commun Res. 2020;17(2):98-103. https://doi.org/10.20879/acr.2020.17.2.98.
29.
Cheng SK, Wong CW, Tsang J, Wong KC. Psychological distress and negative appraisals in survivors of severe acute respiratory syndrome (SARS). Psychol Med. 2004;34(7):1187-95. [PubMed ID:15697045]. https://doi.org/10.1017/s0033291704002272.
30.
Kazem M, Malek Afzali H. [Statistical methods for health indicators of business. Iranian Ministry of Health]. Tehran, Iran: Royan Pajouh Dentistry; 2003.
31.
Duplaga M, Grysztar M. The Association between Future Anxiety, Health Literacy and the Perception of the COVID-19 Pandemic: A Cross-Sectional Study. Healthcare (Basel). 2021;9(1). [PubMed ID:33466487]. [PubMed Central ID:PMC7824811]. https://doi.org/10.3390/healthcare9010043.
32.
Montazeri A, Tavousi M, Rakhshani F, Azin SA, Jahangiri K, Ebadi M, et al. [Health Literacy for Iranian Adults (HELIA): development and psychometric properties]. Payesh (Health Monitor) J. 2014;13(5):589-99. Persian.
33.
Alipour A, Ghadami A, Alipour Z, Abdollahzadeh H. [Preliminary validation of the Corona Disease Anxiety Scale (CDAS) in the Iranian sample]. Health Psychol. 2020;8(32):163-75. Persian. https://doi.org/10.30473/hpj.2020.52023.4756.
34.
Khoshravesh S, Moeini B, Rezapur-Shahkolai F, Taheri-Kharameh Z, Bandehelahi K. [Health Literacy of Employees of Hamadan University of Medical Sciences and Related Demographic Factors]. J Educ Commun Health. 2018;5(1):19-26. Persian. https://doi.org/10.21859/jech.5.1.19.
35.
Safa F, Anjum A, Hossain S, Trisa TI, Alam SF, Abdur Rafi M, et al. Immediate psychological responses during the initial period of the COVID-19 pandemic among Bangladeshi medical students. Child Youth Serv Rev. 2021;122:105912. [PubMed ID:33390637]. [PubMed Central ID:PMC7769705]. https://doi.org/10.1016/j.childyouth.2020.105912.
36.
Heumann E, Helmer SM, Busse H, Negash S, Horn J, Pischke CR, et al. Anxiety and depressive symptoms of German university students 20 months after the COVID-19 outbreak - A cross-sectional study. J Affect Disord. 2023;320:568-75. [PubMed ID:36220498]. [PubMed Central ID:PMC9547656]. https://doi.org/10.1016/j.jad.2022.09.158.
37.
Asadi N, Salmani F, Pourkhajooyi S, Mahdavifar M, Royani Z, Salmani M. Investigating the Relationship Between Corona Anxiety and Nursing Care Behaviors Working in Corona's Referral Hospitals. Iran J Psychiatry Clin Psychol. 2020;26(3):306-19. https://doi.org/10.32598/ijpcp.26.3476.1.
38.
Saddik B, Hussein A, Sharif-Askari FS, Kheder W, Temsah MH, Koutaich RA, et al. Increased Levels of Anxiety Among Medical and Non-Medical University Students During the COVID-19 Pandemic in the United Arab Emirates. Risk Manag Healthc Policy. 2020;13:2395-406. [PubMed ID:33177898]. [PubMed Central ID:PMC7652570]. https://doi.org/10.2147/RMHP.S273333.
39.
Fathi A, Sadeqi S, Sharifi Rahnemou S, Malekirad A, Rostami H, Rostami R. The Effect of the Way of Using Social Media on Health Promoting Behaviors and COVID-19-related Anxiety in Non-medical Students. J Qazvin Univ Med Sci. 2020;24(2):124-35. https://doi.org/10.32598/jqums.24.2.2377.1.
40.
Ziapoor A, Kianipoor N. [Predicting health literacy of students in Kermanshah University of Medical Sciences in 2016: The role of demographic variables]. J Health Literacy. 2016;1(3):182-90. Persian. https://doi.org/10.22038/jhl.2016.10966.
41.
Miri S, Ganji M. [Evaluating Poverty Indicators among Government-Supported Households: A Multidimensional Approach]. Soc Welfare. 2023;22(87):285-319. Persian. https://doi.org/10.32598/refahj.22.87.2046.4.
42.
Hossaini FA, Darya F, Rahmanian V, Sharifi N. Health Literacy and ''COVID-19 Anxiety'' in Iranian Adults: A Cross-Sectional Study. J Health Literacy. 2023;8(1):52-61. https://doi.org/10.22038/jhl.2022.67387.1342.

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Pejman Sheikhha:[PubMed][Scholar]
Shayan Ahmadnezhad:[PubMed][Scholar]
Mohammad Ezati Asar:[PubMed][Scholar]
Elahe Saleh:[PubMed][Scholar]

Journal of Semnan University of Medical Sciences

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Investigating the Relationship Between Health Literacy and Anxiety Related to COVID-19 Among Students of the Faculty of Health, Semnan University of Medical Sciences

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